By John Woolfolk
San Jose Mercury News
SAN JOSE, Calif. — The San Jose Fire Department’s single biggest customer is the county jail, which despite having a round-the-clock, on-site infirmary summons firefighters nearly once a day for emergency medical calls.
Fire officials say that’s four times the per-capita rate of the city’s population at large. But perhaps three out of four of those calls, firefighters say, aren’t really necessary. They say jail staffers often are dialing 911 not so much because paramedics are needed to save a life but simply to have an ambulance transport a patient to the hospital. And those unnecessary calls, fire officials say, make them unavailable for emergencies in the community.
“Some patients exhibit no symptoms that would require a paramedic at all,” said Battalion Chief Kevin Conant. “And a large majority don’t require the level of response that’s coming.”
At the urging of Councilman Pierluigi Oliverio, San Jose’s public safety committee this week asked the city manager and fire department to seek a formal agreement with county authorities who run the jail to reduce unneeded firefighter responses to the main lockup on Hedding Street.
But Santa Clara County Executive Peter Kutras Jr. is not convinced that’s necessary, arguing firefighters respond to 911 calls at the jail just as they do for any other city residents.
“When I have an inmate in need of a 911 response, the same response goes to the jail as goes to the neighborhood,” Kutras said. “I’m not sure why that’s a problem.”
Chief of Correction Edward Flores, who runs the jail, said that with 1,500 inmates at any given time and 70,000 throughout the year, the jail’s emergency medical calls are reasonable.
“Many of those folks are brought to us intoxicated or under the influence of drugs,” Flores said.
But Oliverio, whose district includes the fire station usually summoned to the jail, said the average of 300 emergency calls a year to the jail firefighters cite including six in one recent 24-hour period is “really high.” He said it burdens an already thinly staffed fire department to treat inmates who “already have medical care” in-house.
A complex web of responsibility governs medical response to the jail. The county’s Department of Correction runs the facility, while the county Department of Health provides a doctor and nurses for its infirmary.
Ambulance service in Santa Clara County is provided by for-profit American Medical Response, which holds an exclusive contract with the county’s Emergency Services Agency. But AMR subcontracts with San Jose’s fire department for emergency response within the city.
That means all 911 emergency medical calls in San Jose summon both a four-person fire engine crew and a two-person AMR ambulance crew. The fire engine and ambulance crews each include a paramedic.
Kutras said firefighters insisted on that arrangement. In the 1990s, city officials argued that the fire department could respond to medical emergencies faster and at a lower cost than AMR.
“It seems ironic to me that the fire service is complaining about medical response, when the fire service believes the service model should include parmedics on engines,” Kutras said.
But even though no firefighters have been injured in the jail, fire officials cite concerns about their safety in a secure building where they cannot freely move about or easily communicate. They hope to work out a deal where they would be summoned only as needed to treat patients or fight fires.